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Hagar Khalid, Siegfried Wagner, Laxmi Raja, Josef Huemer, Daniel Ferraz, Konstantinos Balaskas, Dawn Sim, Pearse Andrew Keane; Incident cardiovascular events following paracentral acute middle maculopathy. Invest. Ophthalmol. Vis. Sci. 2022;63(7):1750 – F0210.
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Paracentral acute middle maculopathy (PAMM), a retinal disease characterized by sudden-onset ischaemia of the deep vascular complex, could be the only presenting sign of incomplete central retinal artery or central retinal vein occlusion. Furthermore, isolated PAMM can be the presenting feature of carotid disease. PAMM has the potential to develop more severe ischemic disease which known as the ischemic cascade and may be the result of progressive vascular obstruction.There has been equivocal evidence that PAMM may be associated with cardiovascular events. In this study, we explored the incidence of myocardial infarction and ischaemic stroke following a new diagnosis of PAMM at a large tertiary ophthalmic institution.
A total of 47 patients were newly diagnosed with PAMM by an ophthalmologist specializing in medical retina between January 1st 2008 and December 31st 2017 and had linked secondary care Hospital Episodes Statistics Admissions data. Myocardial infarction (MI) and ischaemic stroke were identified through previously validated International Classification of Diseases 10th Edition codes I21/I22 and I61-I64.
Among the cohort, 28 were male and the average age was 59.0 (12.3) years at diagnosis. Three had myocardial infarctions, one prior and two of which followed an episode of PAMM; there were no cases of ischaemic stroke. Average age at time of MI was 75.3 (9.9) years. The two cases occurred 29 days and 1516 days following the diagnosis of PAMM
In this regional cohort of PAMM, there were no cases of ischaemic stroke and few cases of MI following an episode of PAMM. While underpowered to detect a difference with age-standardised rates of MI, our results did not identify a strong association between PAMM and elevated incidence of cardiovascular events.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.
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